This study examined the long-term results of silicone trapezium arthroplasty. Forty-five thumbs in thirty-five patients were evaluated both clinically and radiographically at a mean of 13.8 years. Forty percent of the implants were dislocated and most dislocations occurred in the first 6 months. One half of the dislocated prostheses were revised due to pain and functional loss. Although pain was improved by the revision, power and function were not. Of the prostheses that were not revised, 19% showed osteolytic changes. One patient exhibited reflex sympathetic dystrophy and one patient had a deep infection. There were no long-term advantages in adding a flexor carpi radialis tendon reconstruction and/or Kirschner wire stabilization.
This long-term study confirms previous reports of reasonable early pain relief from silicone trapezium arthroplasty, but an associated high number of complications and overall patient dissatisfaction mostly due to implant dislocation. Considering the relative good results in the literature using soft-tissue reconstruction methods, this article confirms that silicone arthroplasty should no longer be considered a reasonable option in osteoarthritis of the thumb basal joint.
Link: J. Bone and Joint Surgery